| NPI | 1821523465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON MARCUM Optician 512-458-5367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Additional Taxonomies | 156F00000X Technician/Technologist |
| 156FC0800X Technician/Technologist, Contact Lens | |
| 156FC0801X Technician/Technologist, Contact Lens Fitter | |
| 156FX1101X Technician/Technologist, Ophthalmic Assistant | |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2017-04-20 |